Healthcare Provider Details

I. General information

NPI: 1538075122
Provider Name (Legal Business Name): NICHOLAS GODIN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 SEVELY DR
MOUNTAIN VIEW CA
94041-1601
US

IV. Provider business mailing address

801 SEVELY DR
MOUNTAIN VIEW CA
94041-1601
US

V. Phone/Fax

Practice location:
  • Phone: 650-380-1512
  • Fax:
Mailing address:
  • Phone: 650-380-1512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number95124855
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number95124855
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number95124855
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number95124855
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95124855
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: